Anamnesis

Identification: Sex/Age: Female, 28 years

Medical History: None relevant

Family History: Negative for cerebrovascular diseases

History of Present Illness (HPI): Main symptom: Recurrent headache for 3 months

Pain characteristics:

Location: Frontal and bilateral

Character: Pulsatile

Intensity: 7/10

Triggering factors: Physical exertion, hyperventilation

Duration: 2-6 hours

Associated symptoms:

Transient episodes of paresthesia in the right upper limb

Occasional dizziness

Physical/Neurological Examination: General: Preserved consciousness

Neurological:

No motor or sensory deficits

Normal and symmetrical reflexes

Negative Babinski sign

Complementary Exams: Magnetic Resonance Angiography: Segmental stenosis of the bilateral middle cerebral artery, with characteristic collateral vascular network ("puff of smoke")

Cranial Computed Tomography: No evidence of acute infarction

Transcranial Doppler: Increased velocities in the territory of the middle cerebral arteries

Report this case — e.g. suspected re-identification risk.